Betraying the NHS

by Michael Mandelstam

"Michael Mandelstam's analysis is unanswerable and his criticisms robust. His book should be studied by everyone concerned with how health care is delivered in Britain. If any of the politicians, civil servants or administrators who devised or implemented these changes have the nerve to read it they should hang their heads in shame and resign at once."

This quote, one of many positive reviews of Michael Mandelstam's latest book on the betrayal of the NHS, sums up how hundreds of thousands of people across the country feel about this government's attacks on our health service. Amazingly, the quote is by one of the Tory MPs responsible for starting the attacks on services and introducing the private sector into health care - Tim Yeo, MP for South Suffolk and former Health Minister.

Paul Couchman

Based in Sudbury, Suffolk, and a member of the Walnuttree Hospital Action Committee, Mandelstam uses many local examples of how the government and the Primary Care Trusts are completely out of touch with ordinary people and their health needs.

A highly respected independent legal adviser and trainer in health and social care (previously employed by the Department of Health and the Disabled Living Foundation), he shows clearly how those most vulnerable - such as elderly and disabled people - have been discarded by the NHS and dumped onto local councils who are already overstretched and where they have to pay for services. He points out that health workers have also had to bear the brunt of government cuts.

Using the metaphor of the 'Health Harvest', the book goes into meticulous detail about how the government prepared its Public Relations gurus and the media for endless White Papers and initiatives - full of words like 'choice', 'independence' and 'rights', massive investment and shorter waiting lists. They then put a huge spin on the 'achievements' of the NHS under New Labour.

In Mandelstam's own words: "If it could draw the journalists, its own MPs and the general public into accepting the limited ground of its choosing, then central government might win the NHS propaganda war. It could point to inviting but selective harvests; if other crops went to ruin, well, they could be ignored."

Apart from the facts and figures, showing in black-and-white how the NHS is being prepared for being broken up and sold to the highest bidder, this book contains a comprehensive listing of the demonstrations that have taken place around the country and the estimated numbers involved. Unfortunately, at no point is there any total given, but it is clear that we are talking about hundreds of thousands of people prepared to fight back against the attacks on their health service; Mandelstam talks of the tens of thousands who have demonstrated in Suffolk alone.

This puts to shame those trade union leaders who claim there would not be enough support to call a national demonstration and who have limited action on 3 March to 'local events'. Betraying the NHS shows above all that workers and service users care deeply about their local services and are becoming more and more angry over the cuts - both at their local hospitals and nationally.

A national demo called by the major health unions could channel the anger of those hundreds of thousands of people and, alongside a serious programme of industrial action, could force this government to back off.

Although readers won't find any deep political analysis or any outline of a way forward for workers and health service users in this book, Betraying the NHS: Health Abandoned is a well-researched, blow-by-blow account of the way in which the government has "fragmented and dismantled" the health service in order to "open up provision to the private sector".

Mandelstam's clear and logical arguments, alongside his meticulous research, make this a valuable reference book for any trade union branch or local health campaign or any activist looking for material for speeches, trade union resolutions etc.